Diabetes in Saudi Arabia Dissertation Chapter Example
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Diabetes mellitus is a major public health concern in Saudi Arabia, which is also a prevalent phenomenon in the Middle East and third world countries. Presence of Diabetes mellitus in the human body impedes breakdown of carbohydrates into glucose, which eventually increases the amount of glucose in blood. This condition also hinders how the body utilizes glucose, resulting in severe damage of the nervous system and other body organs. The number of people suffering from Diabetes mellitus in Saudi Arabia is alarming given the estimate of 3.4 million of diabetes prevalence in the Saudi Arabian region (Shaw, Sicree & Zimmet, 2010, p.9). Abandonment of traditional lifestyle and adoption of modern lifestyle has been identified as the main cause of obesity that causes health-related problems such as osteoarthritis, hypertension, stoke, and heart disease. James (2008, p.12)) asserts that the indigenous population of Saudi Arabia has a special genetic predisposition to develop T2DM that is amplified by high rates of obesity and other variables of insulin resistance syndrome.
The results from the study conducted with respect to the case-control study in Saudi Arabia indicated prevalence of diabetes among the Type 2 Diabetes Mellitus group. From the demographic characteristics of control and T2DM groups listed in table 3.1, data showed a higher body mass index (BMI) and waist circumference among the T2DM group, which clearly indicate prevalence of obesity among the T2DM group as expected. As such, the result provides an empirical understanding about the prevalence of T2DM among the overweight individuals and hence, it is implied that the change in lifestyle has caused the occurrence of diabetes mellitus by means of incorporating obesity. In addition, the individuals diagnosed with T2DM also indicated the family history of diabetes mellitus, which indicates the unhealthy eating habits in many families.
Before detection of UCP2 45bp insertion/Deletion polymorphism was carried out, a purity check was conducted on the DNA extracted and all the samples showed a good purity and ratios were always above 1.8. The frequency of the Del/Ins genotype was observed among 34.9% of the study subjects, whereas 58.6% of the total was observed with the Del/Del genotype and only 6.6% of the participants indicated to have the Ins/Ins genotype. This data shows that lack of occurrence of genotype indicating the UCP2 was moderately high among the participants. A chi square value of 0.149 with a P value = 0.928 was determined from the data in order to evaluate the association between UCP2 45bp I/D polymorphism and T2DM. The fact that the P value 0.928>0.05 indicates that the association between the two variables is not statistically significant. This means that our data suggest that there is no association between the UCP2 45bp Ins/Del polymorphism and the development of T2DM in the study population.
In a similar study conducted in Saudi Arabia, the frequency of the Ins/Ins genotype was found to be 21% (19/92) while that of the Del/Del was 79% (73/92) with absence of Ins/Del allele. According to Jiffri (2012, p260), this study did not exhibit any association between UCP2 45bp Ins/Del polymorphism and obesity or T2DM. From findings of another study conducted among the Saudi subjects, the frequency of the UCP2 45bp ins/del was 32.6% and 31.6% among the T2DM and control groups respectively (Jiffri, 2012, p.259). In addition, the p-values of both the T2DM and control groups were found to be 0.476 and 0.441 respectively, which are greater than 0.05 level of significance. In this regard, the results showed that there was no significant association between UCP2 45bp Ins/Del polymorphism and T2DM or control groups. Jiffri (2012, p.261) concludes that in his study, UCP2 45bp Ins/Del polymorphism did not exhibit any significant association with T2DM or control groups among the Saudi subjects although the insertion genotype is in a range among the other ethnic populations.
A similar result was found among the Japanese where frequency of Ins/Del allele was found to be 20% and that of Ins/Ins as 3%. Papazoglou et al (2010, p.309) asserts that UCP2 45-bp Ins/Del polymorphism has no association with morbid obesity. They argue that this polymorphism induces weight loss in metabolically healthy subjects and people with Ins allele have greater reduction in the body mass index. However, Duarte et al. (2003, p.512) reports that, in studies conducted among the Germans and South Indians, an association between UCP2 45bp Ins/Del polymorphism and obesity or T2DM was established. It is worth noting that this disparity in results may have been caused by the sample sizes used in the respective studies.
Although many findings have been reporting a relationship between UCP2 45bp Ins/Del polymorphism and obesity or T2DM, progressions have been made to establish the role of the UCP2 gene with respect to obesity or T2DM. Notably, many studies that have been conducted on the role of UCP2 45bp Ins/Del polymorphism as a risk factor of obesity and T2DM have generated controversial results. For Instance, studies conducted among the American children and Pima Native Americans showed an association of ins/del with increasing BMI and an association of Ins/del with decreasing BMI respectively (Kovacs et al., 2005, p.2293).
Moreover, our data indicates that there is no association between UCP-2 45bp I/D polymorphism and obesity (BMI) for each study group. Table 3.4 shows that the p value for the diabetic group as 0.081, which denotes that that there is no statistical significance between polymorphisms and obesity. Similarly, the p value for the control group was found to be 0.179 that indicates also that there is no statistical significance between polymorphisms and obesity (table 3.5).
The results from our data were not statistically significant in both the control and T2DM groups, which subsequently indicate consistency. Additionally, these results are consistent with Hardy–Weinberg equilibrium (HWE), a law that describes the expected genotype frequencies in a generation and states that allele and genotype frequencies in a population will remain constant from generation to generation in the absence of other evolutionary influences. Data showed similar Chi square values with p value of 0.41, showing that all genotypes have reached the Hardy–Weinberg equilibrium. As a result, UCP2 does not incorporate the irregular accumulation of fats in the body and hence, it is not an antecedent of obesity. In this manner, it is implied that the function of UCP2 is in maintaining the glucose level in blood and hence does not indicate any relation with T2DM. In essence, obesity is found to be developed by other factors other than any genetic prevalence.
Based on the results of this study, it is evident that among the Saudi Arabia subjects, UCP2 45bp ins/Del polymorphism has no significant relationship with either obesity or T2DM. The controversies in results obtained from the studies of this nature can be improved through a replication of a cohort study on the role of UCP2 45bp Ins/Del polymorphism among the obese subjects in various societies as well as among the Type 2 Diabetic subjects. This study provides the basic understanding about the prevalence and antecedents of Type 2 diabetes mellitus and it has been empirically proven that genetic tendencies do not play any role in the occurrence of T2DM. It is observed that the increasing BMI has been playing a significant role in the development of T2DM among many individuals living in Saudi Arabia. It is considered to be the antecedent of inadequate and unhealthy lifestyle, consumption of unnecessary calories and lack of indulgence in the physical activities.
